title: Menopausal symptoms among breast cancer patients: a potential indicator of favorable prognosis.
abstract: Menopausal symptoms have been suggested to be an indicator of better prognosis among patients treated for breast cancer, because women who experience these symptoms usually have a lower level of estrogen. We tested this hypothesis in a population-based, prospective cohort study involving 4,842 women with stage 0 to III primary breast cancer who were enrolled in the Shanghai Breast Cancer Survival Study between March 2002 and April 2006, were aged 20 to 75 years, and were recruited 6 months post-diagnosis. They were followed-up by in-person surveys and record linkages with the vital statistics registry. Cox regression analysis was used to evaluate the association of menopausal symptoms at baseline with breast cancer recurrence. Approximately 56% of patients experienced at least one menopausal symptom, including hot flashes, night sweats, and/or vaginal dryness at baseline. During a median follow-up period of 5.3 years, 720 women had a recurrence. Experiencing hot flashes or having ≥2 menopausal symptoms was associated with lower risk of recurrence among premenopausal women (hazard ratio [HR]=0.77, 95% confidence interval [CI]: 0.62-0.96 for hot flashes; 0.73, 0.56-0.96 for ≥2 menopausal symptoms). Lower recurrence risk in relation to hot flashes was also observed among women who were not overweight/obese (HR=0.78, 95% CI: 0.64-0.99), those with relatively low waist-to-hip ratio (WHR) (HR=0.77, 95% CI: 0.61-0.97), and those who used tamoxifen (HR=0.75, 95% CI: 0.58-0.98). Consistently experiencing multiple menopausal symptoms was associated with lower recurrence risk among women with low WHR or who used tamoxifen. This large, population-based cohort study of women with breast cancer confirms that experiencing menopausal symptoms is an indicator of favorable breast cancer prognosis.
authors.affiliation: Department of Science & Education, Shanghai Municipal Center for Disease Control & Prevention, Shanghai, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Chen
authors.forename: Tsogzolmaa
authors.initials: T
authors.lastname: Dorjgochoo
authors.forename: Ping-Ping
authors.initials: PP
authors.lastname: Bao
authors.forename: Ying
authors.initials: Y
authors.lastname: Zheng
authors.forename: Hui
authors.initials: H
authors.lastname: Cai
authors.forename: Wei
authors.initials: W
authors.lastname: Lu
authors.forename: Xiao-Ou
authors.initials: XO
authors.lastname: Shu
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000503:physiopathology*; D002681:China; D015331:Cohort Studies; D005260:Female; D019584:Hot Flashes / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D007407:Interviews as Topic; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000503:physiopathology; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012044:Regression Analysis; D013546:Sweating / Q000502:physiology; D049629:Waist-Hip Ratio